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Socioeconomic differences in self-medication among middle-aged and older people: data from the China health and retirement longitudinal study.

ABSTRACT: OBJECTIVES:Self-medication with over-the-counter medicines (OTCs) and prescription-only medicines (POMs) are both pervasive in China, although the latter is an inappropriate practice. We examined the relationship between socioeconomic status (SES) and self-medication with OTCs versus POMs. METHODS:Multivariate logistic regressions based on the Andersen framework were estimated using a subsample of respondents aged 45 years and over from the China Health and Retirement Longitudinal Study collected between 2011 and 2013 (n=23?699). As dependent variables, we used OTC and POM consumption without a medical prescription. SES was operationalised by household income per capita and education. Control variables included health indicators, demographic characteristics, and health behaviours. RESULTS:In our study sample, 32.69% and 15.02% of people aged 45 years and over had self-medicated with OTCs and POMs in the 4 weeks before the survey, respectively. OTC use by income exhibited an inverse U shape. Respondents from middle income groups were more likely to self-medicate with OTCs compared with those from the lowest and highest income groups. In contrast, respondents from the lowest income group were more inclined to self-medicate with POMs. There was a clear trend towards more self-medication with OTCs, but not POMs, among those with higher educational attainment. CONCLUSION:People with low income tended to rely on self-medication with POMs for treatment, which is risky and of low quality. A health education programme for older people, particularly those living in low-income households, aimed at improving the quality of self-medication behaviour is warranted. Urgent measures are needed to address the issue of easy access to POMs at community pharmacies, and to improve access to formal medical care among the low-income population.

SUBMITTER: Chang J

PROVIDER: S-EPMC5778336 | biostudies-literature | 2017 Dec

REPOSITORIES: biostudies-literature

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Socioeconomic differences in self-medication among middle-aged and older people: data from the China health and retirement longitudinal study.

Chang Jie J Wang Qing Q Fang Yu Y

BMJ open 20171219 12

<h4>Objectives</h4>Self-medication with over-the-counter medicines (OTCs) and prescription-only medicines (POMs) are both pervasive in China, although the latter is an inappropriate practice. We examined the relationship between socioeconomic status (SES) and self-medication with OTCs versus POMs.<h4>Methods</h4>Multivariate logistic regressions based on the Andersen framework were estimated using a subsample of respondents aged 45 years and over from the China Health and Retirement Longitudinal ...[more]

PMID: 29259056

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Project description:BackgroundAlthough numerous studies focused on the relationship between area socioeconomic status (SES) and health, only a few of them investigated how community-level SES was linked to late-life cognitive function as well as the potential pathways underlying this association, and very few of them focused on the context of China. This study examined how community-level SES was linked to cognitive function and the potential pathways underlying this association among middle-aged and older adults in China.MethodsData was drawn from the waves 1-4 of China Health and Retirement Longitudinal Study. We measured cognitive function with the components of the Telephone Interview of Cognitive Status battery. Community-level SES was derived from a sum of z scores of the percentage of the illiterate and the per-capita net income status within communities. We adopted two-level hierarchical linear regression models to explore the associations between community-level SES and cognitive function. A multilevel mediation analysis with structural equation modeling was undertaken to disaggregate the direct and indirect pathways of the associations.ResultsHigher community-level SES was associated with better cognitive function (β = 0.562, 95% CI = 0.390, 0.734), and this significant association was only present in rural participants, not in urban participants. Furthermore, we discovered the mediating effects of outdoor exercise facilities within communities (β = 0.023, 95% CI = 0.000, 0.056) and individual-level SES (β = 0.108, 95% CI = 0.057, 0.156) to explain the relationship between community SES and cognitive function.ConclusionsThese findings highlight the importance of community environmental interventions in maintaining individuals' cognitive health in China, especially for older adults. Our results provided solid empirical evidence for reducing mental health inequalities in China, and suggested that developing an aging-friendly environment and properly distributing community resources are important to improve cognitive function of older adults.

Dataset Information

Socioeconomic differences in self-medication among middle-aged and older people: data from the China health and retirement longitudinal study.

Publications

Socioeconomic differences in self-medication among middle-aged and older people: data from the China health and retirement longitudinal study.

Similar Datasets

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